NPI | 1003342551 |
---|---|
Former Name | KATHERINE ELIZABETH EUNJEE PRUSS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MI 4704274169) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704274169) |
Enumeration Date | 2017-05-03 |
Last Update Date | 2025-08-18 |